Background: Venous thromboembolism (VTE) is a leading cause of maternal morbidity and mortality, particularly in the postnatal period due to physiological hypercoagulability and additional obstetric risk factors. Pharmacological thromboprophylaxis with heparin is recommended for high-risk postnatal women; however, real-world evidence from hospital-based settings remains limited.

Aim: To evaluate the effectiveness and safety of heparin in preventing venous thromboembolism among postnatal women.

Methods: This hospital-based prospective observational comparative study was conducted in the postnatal ward of a tertiary care teaching hospital. A total of 100 postnatal women within seven days of delivery were included, of whom 50 received heparin prophylaxis as per hospital protocol and 50 received routine postnatal care without heparin. Participants were assessed for demographic and obstetric characteristics, presence of VTE risk factors, occurrence of venous thromboembolism, and adverse effects of heparin. Clinical monitoring and relevant laboratory investigations were performed during the hospital stay. Data were analyzed using descriptive statistics and Fisher’s exact test.

Results: The majority of participants were aged 25–30 years (44%), primiparous (58%), and had one or more risk factors for VTE (66%). Cesarean section was the most common mode of delivery (54%). No cases of VTE were observed in the heparin group, while one case (2%) occurred in the non-heparin group; the difference was not statistically significant (p > 0.05). Heparin was well tolerated, with 80% of women experiencing no adverse effects. Injection site bruising (16%) and thrombocytopenia (4%) were minor and infrequent complications.

Conclusion: Heparin prophylaxis appears to be safe and clinically effective in reducing postpartum VTE, supporting its risk-based use in postnatal women.

KEYWORDS: Venous Thromboembolism, Postnatal Women, Heparin Prophylaxis, Thromboprophylaxis, Maternal Health.